Mr. Durbin (for himself
and Mr. Kirk) introduced the following
bill; which was read twice and referred to the
Committee on Health, Education, Labor,
and Pensions

A BILL

To provide States with incentives to require elementary
schools and secondary schools to maintain, and permit school personnel to
administer, epinephrine at schools.

1.

Short
title

This Act may be cited as
the School Access to Emergency
Epinephrine Act.

2.

Findings

Congress finds the following:

(1)

According to
research funded by the Food Allergy Initiative and conducted by Northwestern
University and Children's Memorial Hospital, nearly 6,000,000 children in the
United States have food allergies.

(2)

Anaphylaxis, or
anaphylactic shock, is a systemic allergic reaction that can kill within
minutes.

(3)

More than 15
percent of school-aged children with food allergies have had an allergic
reaction in school.

(4)

Teenagers and
young adults with food allergies are at the highest risk of fatal food-induced
anaphylaxis.

(5)

Individuals with
food allergies who also have asthma may be at increased risk for severe or
fatal food allergy reactions.

(6)

Studies have
shown that 25 percent of epinephrine administrations in schools involve
individuals with a previously unknown allergy.

(7)

The National
Institute of Allergy and Infectious Diseases (NIAID) has
reported that delays in the administration of epinephrine to patients in
anaphylaxis can result in rapid decline and death. NIAID recommends that
epinephrine be given promptly to treat anaphylaxis.

(8)

Physicians can
provide standing orders to furnish a school with epinephrine for injection, and
several States have passed laws to authorize this practice.

(9)

The American
Academy of Allergy, Asthma, and Immunology recommends that epinephrine
injectors should be included in all emergency medical treatment kits in
schools.

(10)

The American
Academy of Pediatrics recommends that an anaphylaxis kit should be kept with
medications in each school and made available to trained staff for
administration in an emergency.

(11)

According to the
Food Allergy and Anaphylaxis Network, there are no contraindications to the use
of epinephrine for a life-threatening reaction.

3.

Preference for
States regarding administration of epinephrine by school
personnel

Section 399L of the
Public Health Service Act (42 U.S.C. 280g(d)) is amended—

(1)

in subsection (a), by redesignating the
second paragraph (2) and paragraph (3) as paragraphs (3) and (4), respectively;
and

(2)

by striking subsection (d) and inserting
the following:

(d)

Preference for
States Regarding Medication to Treat Asthma and Anaphylaxis

(1)

Preference

The Secretary, in making any grant under
this section or any other grant that is asthma-related (as determined by the
Secretary) to a State, shall give preference to any State that satisfies each
of the following requirements:

(A)

Self-Administration
of Medication

(i)

In
General

The State shall
require that each public elementary school and secondary school in that State
will grant to any student in the school an authorization for the
self-administration of medication to treat that student's asthma or
anaphylaxis, if—

(I)

a health care practitioner prescribed the
medication for use by the student during school hours and instructed the
student in the correct and responsible use of the medication;

(II)

the student has demonstrated to the health
care practitioner (or such practitioner's designee) and the school nurse (if
available) the skill level necessary to use the medication and any device that
is necessary to administer such medication as prescribed;

(III)

the health care practitioner formulates a
written treatment plan for managing asthma or anaphylaxis episodes of the
student and for medication use by the student during school hours; and

(IV)

the student's parent or guardian has
completed and submitted to the school any written documentation required by the
school, including the treatment plan formulated under subclause (III) and other
documents related to liability.

(ii)

Scope

An authorization granted under clause (i)
shall allow the student involved to possess and use the student's
medication—

(I)

while in school;

(II)

while at a school-sponsored activity, such
as a sporting event; and

(III)

in transit to or from school or
school-sponsored activities.

(iii)

Duration of
Authorization

An
authorization granted under clause (i)—

(I)

shall be effective only for the same school
and school year for which it is granted; and

(II)

must be renewed by the parent or guardian
each subsequent school year in accordance with this subsection.

(iv)

Backup
Medication

The State shall
require that backup medication, if provided by a student's parent or guardian,
be kept at a student's school in a location to which the student has prompt
access in the event of an asthma or anaphylaxis emergency.

(v)

Maintenance of
Information

The State shall
require that information described in clauses (i)(III) and (i)(IV) be kept on
file at the student's school in a location easily accessible in the event of an
asthma or anaphylaxis emergency.

(vi)

Rule of
construction

Nothing in this
subparagraph creates a cause of action or in any other way increases or
diminishes the liability of any person under any other law.

(B)

School
personnel administration of epinephrine

(i)

In
General

The State shall require that each public elementary
school and secondary school in the State—

(I)

permit authorized
personnel to administer epinephrine to any student believed in good faith to be
having an anaphylactic reaction; and

(II)

maintain in a
secure and easily accessible location a supply of epinephrine that—

(aa)

are prescribed
under a standing protocol from a licensed physician; and

(bb)

are accessible
to authorized personnel for administration to a student having an anaphylactic
reaction.

(ii)

Liability and
State Law

(I)

Good Samaritan
Law

The State shall have a State law ensuring that elementary
school and secondary school employees and agents, including a physician
providing a prescription for school epinephrine, will incur no liability
related to the administration of epinephrine to any student believed in good
faith to be having an anaphylactic reaction, except in the case of willful or
wanton conduct.

(II)

State
Law

Nothing in this subparagraph shall be construed to preempt
State law, including any State law regarding whether students with allergy or
asthma may possess and self-administer medication.

(2)

Definitions

For purposes of this subsection:

(A)

The terms elementary school
and secondary school have the meaning given to those terms in
section 9101 of the Elementary and Secondary Education Act of 1965.

(B)

The term health care
practitioner means a person authorized under law to prescribe drugs
subject to section 503(b) of the Federal Food, Drug, and Cosmetic Act.

(C)

The term medication means a
drug as that term is defined in section 201 of the Federal Food, Drug, and
Cosmetic Act and includes inhaled bronchodilators and epinephrine.

(D)

The term self-administration
means a student's discretionary use of his or her prescribed asthma or
anaphylaxis medication, pursuant to a prescription or written direction from a
health care practitioner.

(E)

The term
authorized personnel means the school nurse or, if the school
nurse is absent, an individual who has been designated by the school nurse and
has received training in the administration of
epinephrine.

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